手法を比較

	Lawton Ecological Model of Aging	Comprehensive Geriatric Assessment
分野	Social Gerontology	Social Gerontology
系統	Process / pipeline	Process / pipeline
提唱年	1973	1993
提唱者	M. Powell Lawton & Lucille Nahemow	Andreas E. Stuck, Laurence Z. Rubenstein and colleagues (meta-analytic synthesis)
種類	Ecological theoretical framework for aging and adaptation	Multidimensional interdisciplinary diagnostic and care-planning process
原典	Lawton, M. P., & Nahemow, L. (1973). Ecology and the aging process. In C. Eisdorfer & M. P. Lawton (Eds.), The psychology of adult development and aging (pp. 619-674). American Psychological Association.	Stuck, A. E., Siu, A. L., Wieland, G. D., Adams, J., & Rubenstein, L. Z. (1993). Comprehensive geriatric assessment: a meta-analysis of controlled trials. The Lancet, 342(8878), 1032-1036.
別名	Competence-Press Model, Ecological Model of Aging, Person-Environment Fit Model, Environmental Docility Hypothesis	CGA, Geriatric Assessment, Multidimensional Geriatric Assessment, Interdisciplinary Geriatric Evaluation
関連	3	3
概要	The Lawton and Nahemow ecological model of aging, also called the competence-press model, is a theoretical framework that explains the behavior and emotional wellbeing of older people as a joint product of their personal capacities and the demands of their environment. Introduced in 1973, it holds that adaptive behavior arises when the level of environmental press matches a person's level of competence, and that mismatches in either direction produce maladaptive behavior and negative affect. Its most famous proposition, the environmental docility hypothesis, states that as individual competence declines the environment exerts proportionally greater influence on behavior, so settings matter most for the most vulnerable. The model introduced the ideas of adaptation level and zones of maximum comfort and maximum performance, giving environmental gerontology a way to think about optimal challenge. It reframed aging not as a property of the person alone but as a transaction between person and place, with direct implications for designing housing, care settings, and communities. The framework remains foundational for environmental and applied gerontology.	Comprehensive Geriatric Assessment (CGA) is a multidimensional, interdisciplinary diagnostic process that evaluates an older person's medical, functional, cognitive, psychological, social, and environmental status and translates the findings into a coordinated, monitored plan of care. Rather than treating a single presenting complaint, CGA assumes that vulnerability in late life is multifactorial and that problems in one domain spill over into others. Stuck and colleagues' landmark 1993 meta-analysis of controlled trials showed that CGA is not merely descriptive: when it includes control over the implementation of recommendations and structured follow-up, it reduces mortality, increases the chance of living at home, and improves physical and cognitive function. The same synthesis clarified that assessment alone, without the power to act on findings and to follow patients over time, yields little benefit. CGA thus reframed geriatric care around systematic, team-based evaluation linked to action. It became the organizing model for geriatric medicine units, outpatient geriatric clinics, and home-assessment programs worldwide. The method is best understood as a process, not a single scale, even though it is built from many validated instruments.